Birth weight (BW), independent of socioeconomic status, has been identified as a predictor for childhood cognitive development. However, it is not known whether this relation is related to low BW per se or particularly related to a deficit in fat mass (FM) or fat-free mass (FFM) at birth. This study therefore aimed at investigating the relation between body composition at birth and child development at 2 years of age.
An Ethiopian birth cohort was followed up at 2 years. Body composition was measured within 48 h of birth using infant air-displacement plethysmography. Child development was assessed at 2 years of age using Denver developmental screening test. Associations between body composition at birth and development at 2 years of age were tested using linear regression analysis.
FFM but not FM at birth was positively associated with higher global developmental score at 2 years of age (β=2.48, 95% confidence interval (CI) 0.17; 4.79) adjusted for neonatal, postnatal and parental characteristics. This association was attributable to the association with the language developmental domain (β=1.61, 95 CI 0.33; 2.90).
Among Ethiopian children, FFM at birth but not FM predicted better global and language development at 2 years of age. Higher FFM at birth might have exerted a positive effect on the growth and differentiation of the brain and neuronal circuits for better development. This study therefore highlights the need to improve mother's nutritional status during pregnancy in ways that stimulate fetal FFM growth.
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
United Nation (UN). The Millennium Development Goals Report. UN. New York 2013.
You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C et al. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-Agency Group for Child Mortality Estimation. Lancet 2015; 386: 2275–2286.
Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C et al. Early childhood development coming of age: science through the life course. Lancet 2016; 389: 77–90.
Lu C, Black MM, Richter LM . Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level. Lancet Glob Health 2016; 4: e916–e922.
Maalouf-Manasseh Z, Oot L, Sethuraman K . Giving children the best start in life: integrating nutrition and early childhood development programming within the first 1000 days. Technical brief. Food and Nutrition Technical Assistance III Project 2016.
Cusick S, Georgieff MK . The first 1000 days of life: the brain’s window of opportunity: UNICEF. Office of research-Innocenti. Available from: https://www.unicefirc.org/article/958/. (Accessed 13th November 2016).
Grantham-McGregor SM, Lira PI, Ashworth A, Morris SS, Assuncao AM . The development of low birth weight term infants and the effects of the environment in northeast Brazil. J Pediatr 1998; 132: 661–666.
Brooks-Gunn J, Pam Kato K, Fong-Ruey L, Donna S . ‘Enhancing the development of low-birth-weight, premature infants: changes in cognition and behavior over the first three years’. Child Dev 1993; 64: 736–753.
Boulet SL, Schieve LA, Boyle CA . Birth weight and health and developmental outcomes in US children, 1997–2005. Matern Child Health J 2011; 15: 836–844.
Rojahn J, Aman MG, Marshburn E, Moeschberger ML, King EH, Logsdon DA et al. Biological and environmental risk for poor developmental outcome of young children. Am J Ment Retard 1993; 97: 702–708.
Wade M, Browne DT, Madigan S, Plamondon A, Jenkins JM . Normal birth weight variation and children’s neuropsychological functioning: links between language, executive functioning, and theory of mind. J Int Neuropsychol Soc 2014; 20: 909–919.
Deurenberg P, Yap M, Staveren WA . Body mass index and percent body fat: a meta-analysis among different ethnic groups. Int J Obes Relat Metab Disord 1998; 22: 1164–1171.
Nightingale CM, Rudnicka AR, Owen CG, Cook DG, Whincup PH . Patterns of body size and adiposity among UK children of South Asian, black African-Caribbean and white European origin: Child Heart and Health Study in England (CHASE Study). Int J Epidemiol 2011; 40: 33–44.
Stanfield KM, Wells JC, Fewtrell MS, Frost C, Leon DA . Differences in body composition between infants of South Asian and European ancestry: the London Mother and Baby Study. Int J Epidemiol 2012; 41: 1409–1418.
Van SL, Karamali NS, Kanhai HH, Ariëns GA, Fall CH, Yajnik CS et al. Neonatal anthropometry: thin-fat phenotype in fourth to fifth generation South Asian neonates in Surinam. Int J Obes (Lond) 2009; 33: 1326–1329.
Andersen GS, Girma T, Wells JCK, Kæstel P, Michaelsen KF, Friis H . Fat and fat-free mass at birth: air displacement plethysmography measurements on 350 Ethiopian newborns. Pediatr Res 2011; 70: 501–506.
Lee S, Bountziouka V, Lum S, Stocks J, Bonner R, Naik M et al. Ethnic variability in body size, proportions and composition in children aged 5 to 11 years: is ethnic-specific calibration of bioelectrical impedance required? Alemany M (ed). PLoS One 2014; 9: e113883.
Wells JC, Fewtrell MS . Is body composition important for paediatricians? Arch Dis Child 2008; 93: 168–172.
Andersen G, Girma T, Wells J, Kaestel P, Leventi M, Hother AL et al. Body composition from birth to 6 mo of age in Ethiopian infants: reference data obtained by air-displacement plethysmography. Am J Clin Nutr 2013; 98: 885–894.
Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R . New Ballard score, expanded to include extremely premature infants. J Pediatr 1991; 119: 417–423.
Gemechu T, Nigussie B, Wondafrash M, Valy J, Lemmens J, Thijs H et al. Adaptation and standardization of a Western tool for assessing child development in non-Western low-income context. BMC Public Health 2016; 16: 652.
Hadley C, Tegegn A, Tessema T, Asefa M, Galea S . Parental symptoms of common mental disorders and children’s social, motor, and language development in sub-Saharan Africa. Ann Hum Biol 2008; 35: 259–275.
Frankenburg WK, Dobbs JB, Archer P, Shapiro H, Bresnick B . Denver II Technical Manual. In: Denver Developmental Materials. Denver, CO, USA; 1992.
Christiansen TB, Lauritsen JM (ed). EpiData - Comprehensive Data Management and Basic Statistical Analysis System. EpiData Association: Odense, Denmark, 2010.
Larsson J, Aurelius G, Nordberg L, Rudelius P, Zetterstrom R . Developmental screening at four years of age. Relation to home situation, perinatal stress, development and behaviour among Swedish children. Acta Paediatrica 1994; 83: 46–53.
Lawrence M, Christina P, Jane W . Income and child development Center for Research on Child Wellbeing Working Paper # 05-16-FF 2005.
Widdowson EM . Growth and composition of the fetus and newborn. In: Asali NS (ed). Biology and Gestation. Academic Press: New York, NY, USA, 1968, pp 1–49.
Sparks JW . Human intrauterine growth and nutrient accretion. Semin Perinatol 1984; 8: 7 t-93.
Bernstein IM, Goran MI, Amini SB, Catalano PM . Differential growth of fetal tissues during the second half of pregnancy. Am J Obstet Gynecol 1997; 176: 28–32.
Skullerud K . Variations in the size of the human brain. Influence of age, sex, body length, body mass index, alcoholism, Alzheimer changes, and cerebral atherosclerosis. Acta Neurol Scand 1985; 102: 1–94.
Fuglestad A, Rao R, Georgieff M . The role of nutrition in cognitive devel- opment. In: Nelson CA, Luciana L (eds). Handbook of Developmental Cog- nitive Neuroscience. 2nd edn. MIT Press: Cambridge, MA, USA, 2008, pp 623–642.
Pfister KM, Gray HL, Miller NC, Demerath EW, Georgieff MK, Ramel SE . Exploratory study of the relationship of fat-free mass to speed of brain processing in preterm infants. Pediatr Res 2013; 74: 576–583.
Reilly S, Wake M, Bavin EL, Prior M, Williams J, Bretherton L et al. Predicting language at 2 years of age: a prospective community study. Pediatrics 2007; 120: e1441.
Thompson RA, Nelson CA . Developmental science and the media: early brain development. Am Psychol 2001; 56: 5–15.
Kretchmer N, Beard JL, Carlson S . The role of nutrition in the development of normal cognition. Am J Clin Nutr 1996; 63: 997S–1001S.
Georgieff MK, Innis S . Controversial nutrients in the perinatal period that potentially affect neurodevelopment: essential fatty acids and iron. Pediatr Res 2005; 57: 99R–103R.
Stiles J, Jernigan TL . The basics of brain development. Neuropsychol Rev 2010; 20: 327–348.
Ziegler EE, O’Donnell AM, Nelson SE, Fomon SJ . Body composition of the reference fetus. Growth 1976; 40: 329–341.
Pacce S, Saure C, Mazza CS, Garcia S, Tomzig RG, Lopez AP et al. Impact of maternal nutritional status before and during pregnancy on neonatal body composition: a cross-sectional study. Diabetes Metab Syndr 2016; 10: S7–S12.
Nohr EA, VaethM, Baker JL, Sørensen T, Olsen J, Rasmussen KM . Combined associations of pre-pregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr 2008; 87: 1750–1759.
Andres A, Patrick HC, Bellando J, Mario AC, Thomas MB . Effects of fat mass on motor development during the first 2 years of life. Infant Child Adolescent Nutr 2013; vol. 5: 248–254.
Eriksson M, Marschik PB, Tulviste T, Almgren M, Pereira MP, Wehberg S et al. Differences between girls and boys in emerging language skills: evidence from 10 language communities. Br J Dev Psychol 2012; 30: 326–343.
Kuban KC, Allred EN, O’Shea TM, Paneth N, Westra S, Miller C et al. Developmental correlates of head circumference at birth and two years in a cohort of extremely low gestational age newborns. J Pediatr 155: 344–349. e1–3.
Paranjothy S, Broughton H, Adappa R, Fone D . Teenage pregnancy: who suffers? Arch Dis Child 2009; 94: 239–245.
Lejarraga H, Pascucci LC, Krupitzky S, Kelmansky D, Bianco A, Martinez E et al. Psychomotor development in Argentina children aged 0–5 years. Paediatr Perinat Epidemiol 2002; 16: 47–60.
Barker DJ . The origins of the developmental origins theory. J Intern Med 2007; 261: 412–417.
Hoffman ML, Peck KN, Forella ME, Fox AR, Govoni KE, Zinn SA . The effects of poor maternal nutrition during gestation on postnatal growth and development of lambs. J Anim Sci 2016; 94: 789–799.
Hoffman ML, Rokosa MA, Zinn SA, Hoagland TA, Govoni KE . Poor maternal nutrition during gestation in sheep reduces circulating concentrations of insulin-like growth factor-I and insulin-like growth factor binding protein-3 in offspring. Domest Anim Endocrinol 2014; 49: 39–48.
Crume TL, Brinton JT, Shapiro A, Kaar J, Glueck DH, Maria AS et al. Maternal dietary intake during pregnancy and offspring body composition: the Healthy Start Study. Am J Obstet Gynecol 2016; 215: 609.
We would like to acknowledge Jimma University for allowing the research to be conducted and providing logistic support. We also like to acknowledge the Jimma University and University of Copenhagen Alliance in Nutrition (JUCAN) research staff for their unreserved commitment to this research work and the study participants for their time and participation. This study was supported by grants funded by Danish Council for Strategic Research—Program Commission on Food and Health; Danida through the Consultative Research Committee for Development Research (104. Dan.8-1207 and 09-097 LIFE). Funders had no involvement in the conduct and report of the study.
MA, HF, TG, PK, GSA, MT and JW: designed the study; MA, BA, TG, MT, GSA, RW, PK and HF: conducted the study; MA, BA, PK, JW and HF: analyzed data and interpreted the finding; MT, TG, CH, RW and GSA: commented on the interpreted findings and contributed to the write up; MA: wrote the first draft of the manuscript and had responsibility for the whole work. All authors reviewed the content, read and approved the final version.
The authors declare no conflict of interest.
About this article
Cite this article
Abera, M., Tesfaye, M., Girma, T. et al. Relation between body composition at birth and child development at 2 years of age: a prospective cohort study among Ethiopian children. Eur J Clin Nutr 71, 1411–1417 (2017). https://doi.org/10.1038/ejcn.2017.129